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General NPI Number Information
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NPI Number | 1013564970
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Entity Type | Organization
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Legal Business Name | DEZZ, INC
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 735 KINGSBAY RD
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City | SAINT MARYS
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State | GA
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Zip | 31558-3807
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Country | US
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Telephone | 912-673-7777
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Fax | 912-673-1177
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Provider Business Mailing Address
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Address Line | 725 KINGSBAY RD
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City | SAINT MARYS
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State | GA
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Zip | 31558-3807
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Country | US
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Telephone | 912-673-7777
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Fax | 912-673-1177
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER KIM KOLGAKLIS
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Credential |
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Telephone | 912-673-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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